Leading dentists warn an estimated 1.8 million or more over-65s have an urgent dental problem

Leading dentists have warned there is an urgent need to improve oral healthcare for older people. The Faculty of Dental Surgery at the Royal College of Surgeons estimates that across England, Wales and Northern Ireland* at least 1.8 million people aged 65 and over have an urgent dental condition such as dental pain, oral sepsis (a dental infection that can lead to blood poisoning) or extensive decay in untreated teeth. This number could rise by more than 50% by 2040. Dental problems are also linked to malnutrition or pneumonia in older people.

In a new report published today (15 August 2017) dental surgeons raise concerns about the significant impact that poor oral health is having on older people’s general health and quality of life.  The Faculty of Dental Surgery (FDS) is calling for key health and social care professionals to receive training in oral health, and for regulators to make standards of oral care part of their assessments of hospitals and care homes. The Faculty also believes Government, health services, local authorities, care providers, regulators and the oral health profession should work together to improve access to dental services for older people.

Professor Michael Escudier, Dean of the Faculty of Dental Surgery at the Royal College of Surgeons, said:

“That there could be least 1.8 million people aged 65 and over with an urgent dental problem is terrible. We are letting older people down at a time when they need the most help by not having a joined up strategy for improving access to dental services for older people.  

“Many of us know what it’s like to have excruciating tooth or gum pain. It puts you off your food and makes it difficult to do daily tasks. For older people the effects are even worse. It can be very isolating, making people reluctant to socialise with friends and family, and will have a significant impact on their quality of life.

“As well as causing pain and making it difficult to speak, eat and take medication, poor oral health is linked to conditions in older people such as malnutrition and aspiration pneumonia.

“We need to work together to ensure improvements in oral healthcare for older people. Dental health needs to be viewed as part of older people’s overall health, with health professionals and social care providers being trained to recognise and deal with problems.

Over the last 40 years standards of adult oral health have improved dramatically. While just 22% of people in England aged 65 and over retained some of their natural teeth in 1978, by 2009 this had increased to 85% of 65–74 year olds and 67% of those aged 75 and over**. However, this also creates new challenges for dentists, as many older people now require ongoing maintenance of heavily restored teeth.

The report makes a number of recommendations to improve oral healthcare for older people in England, with some also relevant for Scotland, Wales and Northern Ireland. They include:

•    Government, health services, local authorities, care providers, regulators and the oral health profession should work together to develop a strategy for improving access to dental services for older people.

•    Key health professionals in acute and community care settings, such as nurses, junior doctors, pharmacists and geriatricians, should receive training in oral health.

•    Social care providers should provide their staff with appropriate training about oral health and care, as well as ensuring that all services have an oral care policy and cover oral health as part of initial health assessments.

•    Preventative advice on maintaining good oral health should be easily available for older people themselves, their families and their carers.

•    Health and social care regulators should ensure that standards of oral care are assessed during their inspections of care homes and hospitals.

•    All hospitals and care homes should have policies in place to minimise denture loss. These should include checking whether a patient has dentures on admission, and ensuring that staff always check for dentures when disposing of food trays and changing bed linen.

•    More data around older people’s oral health is needed. NHS Digital’s quarterly dental statistics, which only give figures on access to dental services for the overall adult population, should provide a breakdown for people aged 65–74, 75–84, and 85 and over. The Adult Dental Health Survey should also continue to monitor older people’s oral health.

Andrew Kaye, Head of Policy at Independent Age, said:

“Maintaining good oral health is a crucial part of any older person’s overall health and wellbeing and there should be no reason why it gets treated as anything other than a priority. The finding that 1.8 million or more older people have an urgent dental problem is truly shocking. There needs to be a significant step-change in the way health and care services view oral health. This is partly about helping individuals who rely on dentures, but there need to be many other improvements too. With such large growth in the numbers of older people needing dental services, we need to see better preventative advice on maintaining oral health, and strong regulation of hospitals and care homes to ensure that standards on oral health are being complied with and adhered to.”

Last year the National Institute for Health and Care Excellence (NICE) released new guidance on Oral health for adults in care homes (a new NICE Quality Standard has also recently been published on this issue). While this guidance specifically concerns oral health for those in residential care, the Faculty believes it should be used as a benchmark for all types of care provision.

Notes to editors

1.    The Faculty of Dental Surgery at the Royal College of Surgeons of England is committed to enabling dentists and specialists to provide patients with the highest possible standards of practice and care.

2.    *Scotland did not participate in the Adult Dental Health Survey 2009 from which this data is taken.

3.    **Based on data from Health and Social Care Information Centre (2011) 1: Oral health and function – a report from the Adult Dental Health Survey 2009, Table 1.5.1  Proportion of edentate adults: England 1978–2009.

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